Since the Food and Drug Administration, the agency that regulates food and drugs in the United States in March gave its approval last year of Viagra, not succession have left comments, jokes and information, not always clear or scientific.
Everyone wants to know what the blue miracle, as it has come to call. Within two days, the famous pill will be available in pharmacies throughout Spain.
Doctors recommend careful in using this medication, because, like all other drugs, sildenafil citrate also has side effects. Although these are usually mild, there are several contraindications to be observed carefully if you do not want to suffer a health problem that can be sometimes very serious. The expert advice is fully informed before making use of the blue pill.
INTRODUCTION 1 .- How was it discovered Viagra? - Years ago, British scientists unsuccessfully sought a drug for heart failure. However, the researchers found that even caused erections in men suffering from impotence long before the trial. They soon discovered that about 80% of men with erection problems improved significantly.
2 .- What does it look? - Pills foma blue diamond in doses of 25, 50 and 100 milligrams.
3 .- How Viagra works? - Sildenafil involved in the complex process that precedes vasodilation erection. Thanks to this drug, penile smooth muscle relaxes and, consequently, the corpora cavernosa fill with blood and an erection occurs.
4 .- When the revolution began in Viagra? - From a study published in 1996 in the British Journal of Urology, conducted with 12 men suffering from erectile dysfunction. It compared the effect of various doses of Viagra to a placebo. The results found that those who took sildenafil had erections and more frequent. From this work, many trials have established the effectiveness of sildenafil.
5 .- Does it work if there is impotence? - According to the manufacturing laboratory, sildenafil citrate no effect in men who undergo no erectile dysfunction.
6 .- How long do the effects of Viagra? - Since the first half hour and lasts for four hours after its absorption.
7 .- How should I keep it? - Viagra should be in an environment whose temperature ranges between 15 and 30 degrees.
8 .- Can I speed up or slow down its effects? - Si la Viagra se toma en ayunas los efectos se manifiestan antes. When taken after a meal period is delayed.
9 .- Do you leave footprints in sperm? - The concentration of sildenafil on sperm 90 minutes after absorption is only 0.001% of the ingested dose.
10 .- How the body removes the Viagra? - Responsible primarily hepatic metabolism. The 13% is excreted through urine.
11 .- Are there copies of Viagra? - Yes, but offer no guarantee of quality. Risks by buying them seriously threaten their health and lose lots of money.
12 .- There will be a fast-acting Viagra? - Yes, Pfizer, the laboratory contract to manufacture, has announced that a sublingual will reduce the time for action.
SIDE EFFECTS 13 .- Is it possible that it causes cancer? - In some studies, large doses to mice for 20 months without detection of carcinogenic effects in rodents. Other bacterial tests in the ovaries of rodents and in human lymphocytes detected no tumors.
14 .- Can cause sterility? - The sperm of men who took Viagra in preliminary studies was unchanged. Even in mice was observed fertility decline.
15 .- Could harm the fetus? - Rabbits and female rats received up to 200 milligrams of sildenafil per kilo of weight and there was no toxic effect on pregnancy or on the embryos of animals.
16 .- What to do in case of poisoning by Viagra? - Studies show that doses of 800 milligrams cause mild side effects. However, it should go to the emergency services to carry out routine tests which follow massive ingestion of a drug.
17 .- How serious are the side effects of this medicine? - No. However, the use of higher doses more likely to experience side effects more pronounced.
18 .- Is there a risk of erectile to consume Viagra maintained? - There have been no cases of priapism after proper use of sildenafil. However, if it occurs, medical intervention is needed urgently, as the corpora cavernosa may be damaged. Some thoughts about sex Jorge T Colombo
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19 .- What kind of visual disturbances caused by the Viagra? - Abnormalities in color vision (everything looks blue) that can last a few minutes or several hours. Hypersensitivity has also been reported to direct light or blurred vision. Experts think that these problems are due to the presence of phosphodiesterases in the retina.
20 .- Does Viagra causes bone pain? - Have been reported some symptoms of this type. However, no study has linked the consumption of sildenafil.
21 .- Does it increase the incidence of urinary tract and bladder? - He has seen a slight increase of these problems in the wives of the individuals who participated in the trials, but experts attributed it to germs that were incurred during the retaking sexual activity.
22 .- What other side effects have been reported with Viagra? - In less than 2% of those who participated in the trials, there was facial edema, fatigue, abdominal pain, allergic reactions, angina pectoris, syncope, tachycardia, palpitations, vomiting, gastritis, gastrointestinal hemorrhage, gingivitis, depression, insomnia , drowsiness, decreased reflexes, asthma, sinusitis, bronchitis, herpes, urticaria, conjunctivitis and eye pain.
23 .- What can you do about headaches? - Sildenafil may induce this side effect by dilating the cerebral arteries. Usually resolves spontaneously, but to prevent it may be helpful to take aspirin or paracetamol.
24 .- "And with the suffocation? - This side effect is mild and is due to the expansion of small cutaneous blood vessels. A veces tan sólo se produce un mínimo sonrojo del rostro, del cuello o del torso. It is worrying.
25 .- Does it cause nausea or upset stomach Viagra? - This side effect is explained by blood flow experienced by arteries that supply the stomach. Can be avoided with a gastric protective.
26 .- What are the most common side effects? - Nasal congestion, diarrhea, fatigue, headaches, rashes and blue vision.
27 .- Is there really a risk of death associated laViagra? - According to the U.S. Food and Drug Administration, no proof that Viagra has been responsible for the deaths deemed to be related to the medication. Notes that, although sex is a moderate effort can be fatal for people whose cardiovascular status is critical.
28 .- Tell your doctor. - Your specialist should know if you take Viagra. Hide this information can be dangerous, especially if you suffer from cardiovascular disease and presents an emergency episode. You should also tell the people around them or carry a badge to alert doctors if critical events that may lead to unconsciousness.
CONTRAINDICATIONS
29 .- Can I take Viagra with stomach ulcer? - So far, no studies on this topic. However, sildenafil may enhance the anticoagulant effect and make the most dangerous bleeding. For this reason to be cautious.
30 .- "And with retinitis pigmentosa? - This genetic disease affects retinal phosphodiesterases, so experts advise caution.
31 .- Do you protect against sexually transmitted diseases? - No way. The precautions to avoid infections remain the same with or without Viagra.
32 .- Is contraindicated alcohol with Viagra? - Alcohol is associated with Viagra could cause decreases in blood pressure. However, no clinical study has established the incompatibility between the two products.
33 .- Can I smoke and further treatment with Viagra? - Smokers experienced no effects other than those who did not smoke reported in any study.
34 .- "And take it with other drugs? - There seems to be interaction between sildenafil and hashish, morphine or heroin.
35 .- How often can take Viagra? - It is recommended not to take it more than once a day.
36 .- "The dose depends on age? - Yes Men over 65 years, overall, 40% less medication than younger users.
37 .- "Liver cirrhosis is a contraindication for taking Viagra? - No. But keep in mind that the diseased liver is working less and the drug remains active in the body longer.
38 .- What kidney failure? - Viagra is not recommended specifically in this case. However, there are to watch, as it can magnify the effect of sildenafil citrate.
39 .- What is the most appropriate dose of Viagra? - A patient-specific. Usually 50 milligrams are recommended.
40 .- What to do if a child accidentally ingested? - Although it appears the absence of serious damage in case of accidental ingestion, it should quickly consult a pediatrician or go to the emergency room to control cardiovascular constant during the four hours following the ingestion of any drug.
41.- ¿Puede tomar Viagra si sufre la enfermedad de Peyronie? - This condition is a malformation of the penis caused by the sclerosis of some elements that involve the phallus. Erections are often painful and sometimes impossible. In this case, Viagra should be prescribed with caution starting with low doses.
42 .- "And in the case of developing fibrosis of the corpora? - This problem usually occurs by the inappropriate use of intracavernous injections. However, Viagra can be used always starting with low doses and under strict medical supervision.
43 .- Blood diseases.
- Certain anemias, leukemias, myelomas or predispose to priapism. In these cases one must use small doses.
44 .- heart disease and Viagra.
- They are not specifically contraindicated if you are not taking nitrates. However, your cardiologist should monitor the treatment with sildenafil.
45 .- "must be followed to the letter the contraindications? - Yes must be strictly adhered to avoid accidents of varying severity. There are other solutions for impotence, such as intracavernous injections, microsurgery, the vacuum pump or hormone therapy.
46 .- Is there an age limit for using Viagra? - No, but depends on the overall health, especially in cardiac patients.
47 .- "Fatigue real sex? - Not really. However, some men who have a heart tired (history of myocardial infarction, CABG, advanced age, etc.). It can be tiring. In these cases, the risk taken has nothing to do with the medication itself, but with the physical activities that can support each patient.
INTERACTIONS
48 .- Are medications with nitrates are totally banned? - These drugs, used to dilate the arteries and facilitate blood flow can cause a drop in blood pressure which could be deadly when combined with Viagra.
49 .- Can you take aspirin? - Yes, apparently, Viagra does not increase the risk of bleeding.
¿50 .- Incidentally antibiotics in the concentration of Viagra? - In some cases. Studies have shown that erythromycin increases the blood levels of sildenafil 182%. In contrast, rifampin has the opposite effect.
51 .- What drugs potentiate the Viagra? - In addition to erythromycin, some fungal medications such as itraconazole or ketononazol, increase blood levels of Viagra, and hampering its degradation by the liver. Some studies showed the same effect with some anti-ulcer.
52 .- What medications can be taken safely? - Tolbutamide (for diabetics). Warfarin (anticoagulant). Serotonergic antidepressants (like Prozac). Tricyclic antidepressants. Thiazide diuretics. Gastric antacids such as magnesium hydroxide or aluminum hydroxide. Aspirin. Amlodipine (for hypertension).
53 .- Can be combined intracavernous injections and Viagra? - Although no data are available, it is believed that certain men for whom Viagra is not effective, or only what is in extreme doses, the association with intracavernous injections might be useful.
54 .- Are there any drugs that block the action of Viagra? - Numerous studies have shown that consumption of antidepressants, antipsychotics, antihypertensives and diuretics do not affect product efficacy.
55 .- What mechanism enhances the effect of Viagra? - Some drugs use the same system that sildenafil hepatic degradation. The association of one or more of these drugs with the Viagra produces an effect of delaying the liver competitive rate of decomposition of each.
56 .- Can not take sildenafil with male hormones? - When hormone treatment is prescribed properly, restore the powers usually erect. However, in some cases the treatment is not enough. It is possible that the association of hormonal treatment with Viagra can be beneficial. But no scientific study about it.
57 .- "And with other drugs? - Some drugs used in treatments for hypercholesterolemia, hypertension, psychiatric disorders, allergies, etc., may cause some degree of impotence. Viagra is advisable in these cases because it restores erectile capacity without reducing the effect of the drug.
58 .- Does Viagra is comparable to drugs? - No. The Viagra, unlike drugs such as cannabis, ecstasy, morphine or alcohol, does not act on the brain. Its action is only locally on the penis.
59 .- Is it possible to combine Viagra with poppers? - No. These products are based on starch nitrate, a potent vasodilator. So are contraindicated with Viagra (like other nitrates), as they may cause blood pressure drops very serious.
INFORMATION
60 .- What illnesses require special precautions? - Should take a few precautions with respect to certain severe, cardiovascular diseases, liver and kidney.
61 .- What is the mechanism of action of Viagra? - Nitric oxide (NO) is a fundamental free radical in the complex mechanism of erection. Activates an enzyme called guanylate cyclase, which increases local levels of a substance called cíclicoguanosinmonofosfato (cGMP). CGMP facilitates smooth muscle relaxation in the corpus cavernosum penis, allowing increased blood flow causes an erection. Cuando el NO penetra en los cuerpos cavernosos, la Viagra inhibe la fosfodiesterasa tipo 5, lo que aumenta el cGMP e impide que el óxido nítrico sea degradado por la acción de la enzima fosfodiesterasa tipo 5.
62 .- Do you always get an erection? - No. Only if the man is sexually stimulated can get an erection.
63 .- Does Viagra lose efficacy in long-term care? - No. The men who suffered from erectile insufficiency who use Viagra and has for several years (for participating in preliminary trials) have not diminished effect.
64 .- "Sildenafil may cause some dependency? - According to studies, this risk does not exist. Nor is it necessary to increase doses over time to continue getting the desired result and has not been reported any symptoms of physical or psychological dependence.
65 .- Does it increase sexual potency in healthy men? - Viagra is not an aphrodisiac, does not increase sexual desire.
66 .- What do the men who have tried it? - In the 30 or 40 minutes after taking the tablet, the vast majority of men who participated in the trials said that they become more sensitive and receptive to sexual stimuli. They noted, at the same time, they get get an erection or improvement in terms of quality and durability. Side effects are not serious.
67 .- Does Viagra substitute for psychological therapy? - Many disorders of libido and erection have a psychogenic origin. The restored Viagra erection but is unable to solve the very cause of an eating disorder.
68 .- What may be an alternative to antidepressant drugs? - In a way, yes. Men with erectile failure often are undervalued, and Viagra may help them regain their self esteem.
69 .- When Viagra does not work? - Between 20% and 60% of the cases were unresponsive to sildenafil. However, other solutions must be removed for impotence, but most annoying, have shown good results.
70 .- What to do after taking the blue pill? - It is desirable to create an erotic environment conducive for sexual stimulation needed to achieve erection. Without sexual stimulation Viagra is not acting.
71 .- Does it increase the intensity of ejaculation? - Yes studies have shown that men get an orgasm with greatest number of sperm in the ejaculate.
72 .- Can not take Viagra if you are prostate surgery? - Los hombres que han sufrido una prostatectomía tienen eyaculación retrógrada. In these cases, the sperm is projected into the bladder at the time of orgasm and does not appear in the opening of the penis. Viagra can not restore external ejaculation of these people.
73 .- Can gay men use Viagra? - Evidently. The causes, consequences and treatment of erection disorders are exactly equal in male homosexuals and heterosexuals.
COMPETITION
74 .- What drugs will compete in the Viagra? - The most promising drug called Vasomax. This is a drug long used in cardiology, whose active ingredient is phentolamine. Just go through the phase III trials. His approval could take place in 1999 or 2000.
75 .- What is phentolamine? - A molecule of uncertain efficacy used in the field of hypertension that is already described in the formulation of intracavernous injections.
76 .- Do you get the automatic erection Vasomax? - No. As with Viagra have to wait some time. Still, the erection is a lot faster. It is also necessary to achieve sexual arousal erection.
77 .- What side effects have phentolamine? - During the trials with Vasomax, doctors noted no serious side effects. The most common is the feeling of stuffy nose.
78 .- What medications are prohibited Vasomax? - Among those who participated in the Phase III trials, ate some antihypertensives, anti-inflammatory medications for diabetes, normalizing cholesterol, analgesics and anticoagulants. Some were also taking nitrates and no problem was detected among these people.
79 .- How long does it take to act on Vasomax? - From 20 to 30 minutes in most cases.
80 .- How was it discovered this medicine? - Years ago it was known that this drug used to treat high blood pressure falling on the erection. In 1993 was tested with 85 men who complained of erectile failure and compared with a placebo group. 42% of men taking phentolamine was again able to get an erection.
81 .- What is known of Spontane? - What is a new pill erectile failure of action different from Viagra and Vasomax.
82 .- What is its function? - The active ingredient is apomorphine. It acts on the brain, specifically on the nerve centers that regulate the erection after sexual stimulation.
83.- ¿En cuánto tiempo actúa el Spontane? - Between 10 and 15 minutes.
84 .- What are the side effects? - So far, we detected slight nausea, increased sweating, and drowsiness.
85 .- What is Topiglan? - This is a gel to the penis based on a molecule used in transurethral suppositories: the alprostadina. A study released in June found that 80% of the 114 patients who tried it has obtained a firm erection without significant side effects
FOR WOMEN
86 .- Does Viagra improve women's sexuality? - Vaginal lubrication is due in part from the local blood flow. He has just completed the first clinical trial on the effect of sildenafil in women with very good results. In females, this drug increased blood flow to the genital area as in men.
87 .- Do you see the female and male orgasm? - Not really. Women can have several successive orgasms and man. Women's orgasm is not accompanied by ejaculation. It is believed that the best quality of erection of the clitoris and vaginal lubrication may be responsible for an increasing number of orgasms senses during the same relationship and increased the proportion of orgasms achieved.
88 .- Can SUBSTITUTE replace the hormone treatment? - Viagra could represent a breakthrough in women's sexuality in menopause since, except the estrogen treatment, the different local procedures (lubricants or other) used to increase or create vaginal lubrication lost during this stage are ineffective.
89 .- Are there more tests of Viagra in women? - Pfizer is preparing an essay in Sandwich (where they became the first tests in men) with 500 menopausal women who suffer from vaginal dryness. So far, results are not known.
90 .- Could taking Viagra during pregnancy? - No trials have been conducted with pregnant women, although it is thought that sildenafil would not harm the fetus.
91 .- What other drugs could enhance female sexuality? - Viagra is the first candidate. Furthermore, he speculates with other molecules, whose arrival to market is imminent. Especially with the Vasomax and Topiglan (this gel could be applied to the clitoris).
92 .- Viagra Would it help to improve symptoms of menopause? - Viagra may help lubricate the vagina and thereby improve sex after menopause. However, it has the same effect as hormone replacement therapy, used to reduce other problems in this period (osteoporosis, cardiovascular risk, etc.)..
93 .- Can you address the lack of female sexual desire? - Viagra has no effect on sexual desire, therefore, as is the case with men, lack of appetite resulting from emotional conflict is not resolved with sildenafil.
94 .- Would it help buy viagra in painful sexual intercourse? - Not if these pains do not result from a lack of lubrication. Call your doctor to see if the pain is due to an ovarian cyst or endometriosis.
95 .- What women could benefit from Viagra? - For now, Viagra has shown good results in menopausal women who had noticed a deterioration in their sexual activity due to vaginal dryness and rigidity of the walls of the uterus by the lack of estrogen.
96 .- Can use women sexually satisfied? - If authorized for use for women should apply the same criteria as for men. That is, not be taken if there is sexual dysfunction
97 .- How to get Viagra? - Only a doctor's prescription erectile dysfunction has been diagnosed with sildenafil capable of improving and paying the full price set.
